Spontaneous Regression Of Oesophageal Squamous Cell Carcinoma
Khan, H., Casey, P., Hayes, S., Tokala, A., & Sultan, J. (2021). Spontaneous regression of oesophageal squamous cell carcinoma. BMJ case reports, 14(6), e241344. https://doi.org/10.1136/bcr-2020-241344
View Original Source →Abstract
Partial or complete spontaneous regression (SR) of cancer is unusual, particularly in patients with oesophageal cancer. This case report describes a patient with biopsy-proven squamous cell carcinoma of the oesophagus which spontaneously regressed without any treatment. Regression of the primary tumour was confirmed on histological examination of the resected specimen. The process of SR remains an enigma, but potential mechanisms are considered.
Case Details
Disease Location
Esophagus
Personal Characteristics
66-year-old caucasian woman. History of basal cell carcinoma treated surgically. She was an ex-smoker and consumed only moderate alcohol
Clinical Characteristics
8 weeks of progressive dysphagia. Upper gastrointestinal (gi) endoscopy demonstrated a suspicious mid to distal oesophageal stricture. Biopsies were suggestive of squamous cell carcinoma (SCC) in situ. PET-CT confirmed a fluorodeoxyglucose (fdg) avid oesophageal mass and enlarged perioesophageal nodes. Interval endoscopy 2 months later demonstrated a persistent lower oesophageal lesion. Poorly differentiated SCC was confirmed on repeat biopsy
Remission Characteristics
PET-CT, 3 months after the initial scan, showed persistently enlarged nodes but with an overall reduction in bulk of the primary tumour, which was no longer fdg avid. A final endoscopy was performed, and repeat biopsies of the irregular area revealed only high-grade dysplasia.
Treatment & Mechanisms
Proposed Remission Mechanisms
A traumatic ‘insult’ to the tumour may have evoked a focal immune-mediated response.
Clinical Treatment
Biopsy